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442 MIDWAY ISLAND
_ �c ,r.' � t G^ G � �.�''T �J 'U.SlDEPA�cTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE oMg No. �sso-0008 Ex�ires Februarv 28.2009 Fetleral Emer�ency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: uilding Owner's Name ARTHUR NETHERCOAT Policy Number A�Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 442 MIDWAY ISLAND City CLEARWATER State FL ZIP Code33767 A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.) LOT 60,UNIT 3 ISLAND ESTATES OF CLEARWATER A4. Building Use(e.g.,Residential,Non-Residentiai,Addftion,Accessory,etc.)RESIDENTIAL A5. LatitudelLong(tude:Lat.27 DEG 58'B9"N Long.82 DEG 48'49"W Horizontai Datum:❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number� A8. For a building with a crawl space or enclosure(s),provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or encl�sure(s) N/A sq ft a) Square footage of attached garage 2179 sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade 13 c) Total net area of flood openings in A8.b Q___ sq in c) Total net area of flood openings in A9.b �82 sq in � � SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name 8�Community IVumber 62.County Name 63.State CITY OF CLEARWATER 125096 PINEU.AS FLORIDA B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel 68.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C0102G G MAY 17,2005 SEPT.3,2003 AE 11 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69. ❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe) B11 Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 I�NAVD 1988 ❑Other(Describe) B the building located in a Coasta!Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No �esignation DateNONE ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings* ❑Building Under Construction* �Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. �tA C2. Elevations-Zanes A1 A30,AE,AH,A(with BFE),VE,V7-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complet � � below according to the building diagram specified in item A7. � � Benchmark Utiiized PINELLAS BM."AURAL A"Vertical Datum NAVD88 z ii ConversionlComments NGVD29-p.86 FT.=NAVD88 � o W�° Check the measurement used. �° G�.�, a a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 5.¢ �feet ❑meters(Puerto Rico only) � W�� b) Top of the next higher floor �5.� �feet ❑meters(Puerto Rico only) (�n o Q[ c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters(Pusrto Rico only) c.� ��_ d) Attached garage(top of slab) 5.6 �feet ❑meters(Puerto Rico only) L�J � �` e) Lowest elevation of machinery or equipment servicing the building 11.0 �feet ❑meters(Puerto Rico only) z� �[ (Descnbe type of equipment in Comments) � � fl Lowest adjacent(finished)grade(LAG) 5.2 �feet ❑meters(Puerto Rico only) �� g) Highest adjacent(finished)grade(HAG) 5.3 �feet ❑meters(Puerto Rico only) �-� t?-_. SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or archited authorized by law to certify elevation < � information. t cerfify that the information on this Certificate tepresents my best efforts to inteip�t the data available. :• � ;,,,�,�:, �, : 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. . �.�. �. -'.�t�,; ���,� , .,, � Check here if comments are provided on back of form. , � ��.�' ��,.6 Ce ifier's Name MICHAEL J.BAKER Ucense Number LS 4086 �/ � e = a,��_��, � w , ND SURVEYOR Company Name MICHAEL BAKER ASSOCIATE3 - / � � � j'`' 4'�9�s�� ��'�° �.�`�'` . Address 220 S.SAFF AVE. City TARPON SPRINGS State FL ZIP Code 34689 `.% ��a �� ° `� .�_��e9,, `',��9tf��/'' �,,..y�. ! `a� Signat .s� Date DECEMBER 1,2007 Telephone 727-938-5026 ��Q�'v�t�cg:���Gb��"�'�� 'f ,� � � J �c�i�0(p' ��-�� — +ry^;f •�'�*,R .,y � * M, ' ..,, � '�R w. IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company:1s�: Building Street Address(including Apt.,Unit,Suite„and/or Bldg.No.)or P.O.Route and Box No. Policy Number - ' 442 MIDWAY ISALAND City CLEARWATER StateFLZiP Code 33767 Company NAIC Number ' SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION (CONTINUED) � Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. Comments C2(e). BOTTOM OF ELECTRIC METER BOX(AIR CONDITtONING CONDENSOR ELEVATION=14.6). � Sigaature Date 12I0112007 �2 � ���_ ❑ Check here if attachments SE ION E-B DING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND 20NE A(WITHOUT BFE) For Zones AO and A{without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico oniy,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,craw�space,or enclosure)is ❑feet ❑meters ❑above or 0 below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is . ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is . ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is . ❑feet ❑meters ❑above or�below the MAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,B,and E ars comect to the best of my knowledge. Property Owners or Ownets Authorized Representative's Name Address City State ZIP Code • Signature Date Telephone Comments , .�.. _ ,. ._:._...._.. ❑Check here if atiachments � SECTION G-COMMUNITY INFORMATION(OPTIONAL) :-:, The local official whd is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B.C(or E), ::. and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. ,, <G1.[�. The inforrrration in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by I�w to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) �`�G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. ,. .:;G3.❑ The foflowi�g information(Items G4.-G9.)is provided for community floodplain management purposes. �,a; G4.Permit N�Fnwbe. G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued s�- - ... .,.,.. , ;. G7.'�, ' ' t�_�ia§been issued for: ❑New Construction ❑Substantial Improvement . ���1'►�.. . ,.....M....�.... g ) 9 GS.�levation of as-built lowest floor(includin basement of the buildin : _�feet ❑meters(PR) atum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum Local Official's Name Title Communiry Name Telephone Signatura ._ �. _.. . ,, Date �dmments � .: r�r'� � .� :t� .) it � ., {j .��: ei i' �� ' �` ❑Check here if attachments � ' Building Photographs ; See Instructions for Item A6. For Insurance Company Use: uilding Street Address(including Apt, Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 442 Midway Island City State ZIP Code CompanyNAlCNumber Clearwater Florida 33767 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. e • � . f.�■ _ �.._ - � �� i r ' i ra � -- � , ` —� � -- �. a�'Irr 1 - „,.._; ... " i - � � �i , ! � � �� ��� � �'i��� T� ( =�"r. � ;�. •ill �� ��� � �� j . - ..,. . .� y r i —, - � � � � : i _ ' I�■ :` _ ;� i , 1 � ',�� � i � _ I i I.i �� � � ' � � -� � -�— �� s � _ � � � , _� , ��� � ,, I _ . ��. �� - ■ � ,; F. . � � ,� `,�� � �f ; ��.� - --_- �" � � � , �1� ��' � �- � � �T` ' , ,�- _ :� � -_� , .�: � � � --- � � # �- - - � ' ���:. _ ■� I�I �� ! _ � _� , � � �'�, [ � � I _� � '-�.- ` — '���rlil +��,. _�-_- •��.- _ �--_ �r, J � :." � ..�_.._ . . , , '"`- --- �=T9C� -�— , - :��:... -- "� .� �,� _ �� ��• `�.�r., ■ Y� ... I .�. .. - � . i _. , . . ---__ � � . . ._ . - . �- - < , ! �. " R �— � � ��_ IF#� ` ..�_ ',. I ' � ' I.�4 �� __� � �t�� � __" ` � �I's .... . iI � _ _ . ;-1� �'T. .-1� , . 1 ..._ ,. . _— `\ ..����'�`` - = 1 � ' — . _ . � - r_ .. �.r 4. - ! .,, ...�� , ..S '_ , ' . �� , I -" 1 i • '�--' - + ��! � � �:�. � — - . � �.� �, � � ��� � - -- � � - - - � �� � � � � � . �� -.-�� ::, .` ��_ _ _J - � � , , =., . - . � � .,,�,:s� .. ' .__ , � - — -- • r:.i..�-��,�. •,_ ,.. � -, .��:.����- - -�.��� 1;�. � __�`.�,a �1 -;::` , FRONT VIEi� � REAR V - i / ° . �� 7 1 „��' �� ,, �.� ,� , T�'��� _ � _ 5 2D1 � :� ; ,�,, pa?' •, '*°.^A,�' ' �` •,�r,, � ,�-,�-}' ��� t �e a:��t�'�` p NIN�&DEVELOPMENT SVCS CITY OF Cl.EARWATER..._� . � . Buiiding Photographs Continuation Page For Insurance Company Use: Building Street Address(including Apt, Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 442 Midway Island �tY State ZIP Code Company NAIC Number Clearwater Florida 33767 If submitting more photographs than will fit on the preceding page, a�x the additional photographs below. Identify all photographs with: date taken; "Front View" and"Rear View"; and, if required, "Right Side View" and "Left Side View." ! �. --� �► ! �! a�� ,� �� � - �� �� ,.,.:���,. � � \ �1� �;��,►���1��' ��f '��, \ ' j , � +h.,� ` ��;"�� � �ti �„!� �� _, �' � '�'�� � t �� � �A �`_�; ' .. / � � ' ����� �� �' �� ' �� ����� � � � � � ' � � � ;� `� ' ,..,� � , ;. , �� � � �� � � � � ,�. �� . �••.. _ � -�, i + , , I�; � � I �� �� �� � ~� I-�• .. I ' ' ' � ' � , I � ; � • � ,�,� � �� � �� � � � � ,� � , � �� , : ` ; ,� , � � ' - �� � , ,�� ��; d�. � : , i , ! , .: ... , �r ��I I� � - I � � �� � ...� _ � �, �, � 11 Q � Q � � d � U � `� �E.0 0 5 2007 , ,.a� � A � x+4 }4•\�� 4` '°�./��A�y't'Z . �� �'• `�` ':"~'� a�C)�"-' _ `: �P ` � pLANNING&DEVELOPMENT SVCS � ° N °4;A�' ��� � CITY OF CLEARWATER - ` ' =�-`' " SIDE . VIEW � ^ `''%' ` � " e ° � •,r, 4�i a� 'ti 0 ��. �`� o m �'° .,'� �� �� ��. V J �� � ���� a� � �� � ��"� ��•`�{'�64�z�0 ' �sr�p�#'� `��� ��f�j� CITY OF CLEARWATER 4'���`,°'`���`:�.`� � �@y`�`��� � � � � <7 w�: ;_� �` DEVELOPMENT & NEIGHBORHOaD SERVICES DEPARTMENT �,�"�'a---_=.:.- '�°k ����+����nx�* ���� POST OFFICE BOX 474H� CLEARWATER� FLORIDA 3375g-4748 °v�.�Iq���� �� MUNICIPAL SERVICES BUILDING, ZOO SOUTH MYRTLE AVENUE,CI.EARWATER, FLO�unn 33756 �"' � ? �'`«"�'� TELEPHONE�7Z� 562-4567 Fnx(727) 562-4576 MEMO OF REVIEW FOR CORRECTNESS 8� COMPLETION In accordance with participation in the NFIP/CRS program,all elevation certificates are required to be reviewed for correctness and completion prior to acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of elevation certificates. The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community The attached elevation certificate is complete and correct _X_Minor corrections have been made in the below marked sections by Community Official SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Policy Number A2. Building Street Address(including Apt., Unit,Suite,and/or Bidg.No.)or P.O. Route and Box No. Company NAIC Number City State ZIP Code A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) A4. Building Use(e.g., Residentiai,Non-Residential,Addition,Accessory,etc.) A5. Latitude/Longitude: Lat. Long. Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage,provide: • a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage sq ft b) No.of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade c) Total net area of flood openings in AB.b sq in c) Total net area of flood openings in A9.b sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION B1. NFIP Community Name&Community Number B2.County Name B3.State 64. Map/Panel Number 65.Suffix B6. FIRM Index 67.FIRM Panel B8.Flood B9. Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C-0102 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile ❑ FIRM ❑Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 ❑ NAVD 1988 ❑Other(Describe) 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings" ❑Building Under Construction" ❑Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized Vertical Datum Conversion/Comments Check the measurement used. e) Lowest elevation of machinery or equipment servicing the building 14 . 6 �feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) Comments: �of Review: � Community Official: • Al1 e/evation certificates shall be maintained by the community and copies with the attached memo made available by request FRANK HIBAARD,MAYOR GEORGE N.CRE"1'LKOS,COUNCILMEMAER JOIIN DORAN,COUNCILMCMBER PAUL F.GIASON,COUNCILMEMBER � C.aw.eK A.PcreasEK,COUNCILMGMRER ��EQUAL EMYLOYMENT AND AFFIRMA"CIVE AC1'ION EMPLOYER�� !3 G r .a c� c� �. -�- . r ..� S.DEPARTfv1ENT OF HOMELAND SECURITY ELEVATION CERTIFICATE onne No. ,s6o-oo0 , Exnires Februarv 28. 2009 a .deral Emergency Management Agency ational Flood Insurance Program Important: Read the instructi�ns on pages 1-8. "� � ����� . SECTION A-PROPERTY INFORMATION For insurance Company Use: �' �ng Owners Name ARTHUR NETHERCOAT Policy Number a�. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number �42 MIDWAY ISLAND City CLEARWATER State FL ZIP Code33767 43. Property Description(Lot and Block Numbers,Tax Parcel Number,Legai Description,etc.) _OT 60, UNIT 3 ISLAND ESTATES OF CLEARWATER a4. Building Use(e.g.,Residentiai,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL a5. Latftude/Longitude:Lat.27 DEG 58'59"N Long.82 DEG 48'49"W Horizontal Datum:❑ NAD 1927 � NAD 1983 a6. Attach at least 2 photographs of the building if the CeRificate is being used to obtain flood insurance. �7. Building Diagram Numberfi A8. For a building with a crawl space or enclosure(s),provide A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage ot attached garage 2179 sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enciosure(s)walls within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade ,�'43'� c) Total net area of flood o enin s in A8.b 0 s in c Total net area of flood o enin s in A9.� 1582 � s in '�...... ..o+" SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 31.NFlP Community Name&Community Number 62.County Name B3.State :.ITY OF CLEARWATER 125096 P�N��S FLORIDA B4. Map/Panei Number B5.Suffix B6.FIRM index 67.FIRM Panel B8.Fiood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date 2one(s) AO, use base flood depth) 12103C0102G G MAY 17,2005 SEPT,3,2003 AE 11 10. Indicate the source of the Base Fiood Elevation(BFE)data or base flood depth entered in ltem B9. ❑ FIS Profile �FIRM ❑Community Determined ❑Other(Describe) I 1. �te elevation datum used for BFE in item 69: ❑ NGVD 1929 �NAVD 1988 ❑Other(Describe) e building located in a Coastal Barrier Resources System(CBRS)area or Othervrise Protected Area(�PA)? ❑Yes �No Jesignation DateNONE ❑CBRS ❑OPA SECTION C -BUILDING ELEVATION INFOf2MA7'lON (SURVEY REQUIRED) I. Building elevations are based on: ❑Construction Drawings* ❑Building Under Construction� �Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. �"'""`"`""°�, ?. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete t SC2:a-g- � be(ow according to the building diagram specified in Item A7. ''i uti; c Benchmaric Utilized PINELLAS BM."AURAL A"Vertical Datum NAVD88 � s Conversion/Comments NGVD29-0.86 FT.=NAVD88 � �` �' � Check the measurement used. ,�-1 � Top of bottom floor(including basement,crawl space,or enclosure floor)_ 5.6 �feet ❑meters(Puerto Rico oniy) � =�« �;� b) Top of the next higher floor 15.2 �feet ❑meters(Puerto Rico only) � � y� c) Bottom of the lowest horizonta!structural member(V Zones only) N/A. ❑feet ❑meiers(Puerto Rico only) ;__; i� d) Attached garage(top of slab) 5.6 �feet ❑meters(Puerto Rico only) i�yi' , � � = ' e) Lowest elevation of machinery or equipment servicing the building 11.0 �feet ❑meters(Puerto Rico only) � (Describe type of equipment in Comments) �f?� , � � fl Lowest adjacent(Snished)grade(LAG) 5.2 �feet ❑metecs(Puerto Rico oniy) f____.,,�.�^�� �- g) Highest adjacent(finished)grade(HAG) 5.3 �feet ❑meters(Puerto Rico only) ' �"'� �j SEGTiON D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION -his certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation nformation. I certify that the infonnation on this Cerlifrcate rep�sents my best efforts to interpr�t the data available. unde�stand that any fafse stafement may be punishabte by fine or imprisonment under 18 U.S. Code, Section 1001. ,!,��° �;;%�;a j��„ f f, � Check here if comments are provided on back of form. �' f i����,.,/ ;'j� �r ' � v "-:���L. - ;e Name MICHAEL J.BAKER License Number LS 4086 , rf!1 ,f .` �--- �4ND SURVEYOR Company Name MICHAEL BAKER ASSOCIATES ' :�.' f`"� J��J/Y"�`.. . � % ° �ddress 220 S.SAFFORD AVE. City TARPON SPRINGS State FL ZIP Code 34689 _ `', �,� ,� � . - 1� r � �, ;ignature-`!:' � ,�j' ;:-�' .-� Date DECEMBER 1,2007 Telephone 727-938-5026 ' �� - �. i�(�:�t'�r-,/ _ r-;��-�1� � I I � I� ���e �ss� i �� a�e�. o� �/��'� o� .� .� � �� � � , � � � � i � �� �e o���1.� c����: �' r� � /� �- ��S r � � � G�t�� l�� '� � � �: ,, � � � � ��e� � ��� �� __ _ 1 - ��� ��.�: _ • � «L i �., ... ..- � - . . .. U.S.DEPAf�iTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE oMB No. �sso-000s Fetlerai Emergency Management Agency Ex�ires Februarv 28. 2009 Nati�nal Floot!Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: P" 8uilding Owner's Name ARTHUR NETHERCOAT Policy Number ! Building StreetAddress(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 442 MIDWAY ISLAND City CLEARWATER State FL ZIP Code33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 60,UNiT 3 ISLAND ESTATES OF CLEARWATER A4. Building Use(e.g.,Residential,Non-Residential,Addition,Aecessory,etc.)RESIDENTIAL A5. Lat(tudelLongitude:Lat.27 DEG 58'59"N Long.82 DEG 48'49"W Horizontal Datum:❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certiflcate is being used to obtain flood insuranCe. A7. Building Diagram Number6 A8. For a building with a crawl space or enclosure(s),provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage 2179 sq ft b) No.of pertnanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade 13 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 1582 sq in _ ^ SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name 63.State CITY OF CLEARWATER 125096 PINELLAS FLORIDA B4.Map/Panel Number B5.Su�x 66.FIRM Index 67.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C0102G G MAY 17,2005 SEPT.3,2003 AE 11 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑FIS Profile �FIRM ❑ Community Detertnined ❑Other(Describe) 611. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 I�NAVD 1988 ❑Other(Describe) � ;the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(�PA)? ❑Yes �No Jesignation DateNONE ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings' ❑Building Under Construction` �Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. � C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,ARIAE,AR/A1-A30,AR/AH,AR/AO. Complet t�.�.� � below according to the building diagram sQecafied in Item A7. �] � Benchmark Utilized PINELLAS BM."AURAL A"Vertical Datum NAVD88 � � Conversion/Comments NGVD29-0.86 FT.=NAVQ88 � ~ u 0 Check the measurement used. N C c� a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 5.6 �feet ❑meters(Puerto Rico only) � u b) Top of the next higher floor 15.2 �feet ❑meters(Puerto Rico only) ntUt o C c) Bottom of the lowest horizontal strucTural member(V Zones only) N/A. ❑feet ❑meters(Puerto Rico only) c.� d) Attached garage(top of slab) 5.6 �feet ❑meters(Puerto Rico only) L�I 0 4 � e) Lowest elevation of machinery or equipment servicing the building 11.0 �feet ❑meters(Puerto Rico only) � (Describe type of equipment in Comments) � . � � Lowest adjacent(finished)grade(LAG) 5.2 �feet ❑meters(Puerto Rico only) �^c_���..,.1�+.� a g) Highest adjacent(finished)grade(HAG) 5.3 �feet ❑meters(Puerto Rico only) _,:'_,;r�� {3 SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. !certify that the information on this Certificate r�presents my best efforts to interpret the data availabfe. i understand that any false stafement may be punishabte by fine or imprisonment under 18 U-S. Code, Section 1001. �r �i' /f,' / � Check here if comments are provided on back of form. /-; � �;,;: .- Certifier's Name MICHAEL J.BAKER License Number LS 4086 � � r%� `7`���- � . i lr �4 •�NDSURVEYOR CompanyNameMICHAELBAKERASSOCIATES -l��'�({( 1���%�, / Address 220 S.SAFF AVE. City TARPON SPRINGS State FL ZIP Code 34689 � l � j / �'' `f �%". Signat f t ! � Date DECEMBER 1,2007 Telephone 727-938-5026 • �,��` , � � , � �� � � " f `�X.��G���r��- ��-�� IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company UsA: Building Street Address(including Apt., Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. Policy Number • . 442 MIDWAY ISALAND . City CLEARWATER StateFLZIP Code 33767 Company N/#IC Number • SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. • Comments C2(e). BOTTOM OF ELECTRIC METER BOX(AIR CONDITIONING CONDENSOR ELEVATION=14.6). /r ,/',/"' ,f Signature �`/%� _ .�� �/ ,.E'� `� Date 92/01I2007 � Check here ff attachments �%C-��� � SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND 2(?NE A(WITHOUT BFE) -- For Zones AO and A(without BFE),complete Items E1-E5. If the Certlficate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4, use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters_ E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(FIAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Buiiding Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(sae page 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the auiiding is ❑feet ❑meters ❑above or[�below the MAG. E5. Zone AO oniy: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION �.....:...... � o a c a.,���h�n n.,trr,..��r a FFMA-ic�iia[i�r communitv-ISSU2d BFE) The property owner or owners auinorized represen4aiive wi�u�u���Nlatas���.�����.�,,�,a�..��... ........--._. or Zone AO must sign here. The statements in Sections A,B,and E are cor►�et to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code • Signature Date Teiephone Comments.._ _ . :.:._, .: :,;,,_ ___.-t:: -•. _ ❑Check here if attac men� , � SECTION G-COMMUNITY INFORMATION (OPTIONAL) r The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can comp�ete Sections A,B,C(or E), -�; and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. -:G1. � The infortrration in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who - is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) ~,-'G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. :�G3. ❑ The fo"ik���rvi�g information(Items G4:G9.)is provided for community floodplain management purposes. ��.: _�;� . G4. Permit Nyp�be. G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued �.- . �_... ,� I G7 '�'h�t���been issued for. ❑New Construction ❑Substantiat Improvement , ,�.,....,.��.�._.. . � G8.Elevation of as-built lowest floor(including basement)of the building: _0 feet ❑meters(PR)Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum L.ocal Official's Name Title Community Name Telephone ,Signature _:--... _:,: -,., i Date . � � :�omments . :' �7',t�i �� �' � . '.'��' ;,. , f.z,, :�. !i :,1: �f �".'�---'= �� ❑Check here if attachmenl � � Building Photographs See Instructions for Item A6. For Insurance Company Use: ding Street Address(including Apt, Unit, Suite, and/or Bidg. No.)or P.O. Route and Box No. Poiicy Number 442 Midway Island City State ZI P Code Company NAIC Number Clearwater Florida 33767 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. . , fi - ,,x., ;i s 1 � al 1 L� ...,. V ..: , ____ � �:; -- �. f 1 y � Y t ;f �.. V � � � x , �� � ,� ` �_ r / ��� ` � ��l � � �� ���� � �f �. �A �� � g�; � �,���� �� � '' ' } .._ - �, , , � � � , _ F , , � , ,. .. � � .� � �. ti ri �� . � _ ' i ,�,�,`� ��I�""�+` � � . � , � _ . , , � � � -. = �� �� :.'� � � � _. 4 ,� .. ��` � ,� - � ���:: � . � I � � � � o�� _ �, „ �i. �� � � , }:� r � _, ,�_ «. ° � 3:. _.... a ' � � > �. a� y �� �.''"\--�,, . . j�� � s � > ; ■ ' .u.` - �� �. � . '� . �� � ��� ` ' � ,, R. � �� � � . - � � � , _ �fi` %� �� i � ��� � ° ,., •. f ...� �f ���_ � ,. � � 4 A . � �� ,�,ac.'�.6� ' . .-�+�,�." . . � 4 , . � �� �' ) �'��", _ ; '�}��. � `t � , . � �^ u . : r, . ... . ,-'� . � , 5 , n : • , . s< . ...( '. � , , .. ; . � , ...,. . _ , .; .' _ � . � i � . t3 *... �:,°.� ,� ,�.sr � .. ..;�z .� �. ,. :� _,....�-- ,. .,.— .... .:. --� €�v�;.;� _ a- ;.,. g ._....w._..sw..,...W..�.,.,{.��,�,..��� ��� 7�` � � � U `�jr ' ��� � FRONT VIEW ,, REAR V — s�� • ' ��: �•'� �' � j �^ i � 4 �;� % % � �� ��� I t� � C���� 1 � � � ✓ ' .J�" .l __,J ;�� j/�j � ���� �� �.%�� �i` � t�'�" �'' pLRNN�IVG&DEVELOPMENY SVGS ,�__ CITY_OF CLEARWATER � (,G r /W a+ v �s -� / / �/ U.S. DEPARTMENTOF HOMELAND SECURITY ELEVATION CERTIFICATE oMB No. �sso-000s Faderal EmePg�ncy Management Agency ExDires Februarv 26. 2009 National Flood Insurance Program Important: Read the instructions�n pages 1-8. � SECTION A-PROPERTY INFORMA710N For Insurance Company Use: P' 8uilding Owner's Name ARTHUR NETHERCOAT Policy Number �uilding Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number IDWAY ISLAND City CLEARWATER State FL ZIP Code33767 A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number, Lega�Description,etc.) LOT 60,UNtT 3 ISLAND ESTATES OF CLEARWATER A4. Building Use(e.g.,Residential,Non-Residential,Addftion,Accessory,etc.)RESIDENTIAL A5. Latitude/Longitude:Lat.27 DEG 58'S9"N Long.�DEG 48'49"W Horizontal Datum:❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building ff tt►e Certificate is being used to obtain flood insurance. A7. Building Diagram Numberf A8. For a buiiding with a crawl space or enclosure(s),provide A9. For a building with an attached garage,pro r� a) Square footage of crawl space or enclosure(s) NIA sq ft a) Square footage of attached garage 2179 sq ft b) No.of permanent flood openings in the crawl space or b) No.of peRnanent flood openings in the ed ga� enclosure(s)walls within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade �--� c) Total net area of flood openings in AB.b 0 sq in c) Total net area of flood openings in A9.b(1582; sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION ._.�_._.,.� B1.NFIP Community Name&Community Number B2.Coun ame � B3.State CITY OF CLEARWATER 125096 F'�NEL' ' FLORIDA 64. MaplPanel Number 65.Suffix B6.FIRM Index B7.FIRM Pane 8. lood B9.Base Flood Elevation(s)(Zone Date � -EffeetivefRevisec ate^ AE(s) AO,use bas�e�flood depth) 12103C01�2� G MAY 17,2005 . , , 'v 810. Indicate the source of the Base Flood Elevation(BFE)data o base flaod depth entered in Ite�rr'�9. ,,,....- ❑FtS Profile �FIRM ❑Community Determin�tl ❑OtbeF{fl�scribe) B11. Indicate elevation datum used for BFE in Item 69: [�NGVD 1929 �NAVD 1988 ❑Other(Describe) B1 a the building located in a Coastal Barrier Resources System(CBRS)area or Othe►wise Protected Area(OPA)? ❑Yes �No �esignation DateNONE ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings* ❑Building Under Construction' �Finished Construction A new Elevation Certificate will be required when construction of the building is complete. � C2. Elevations-Zones A1 A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complet G� below ac:corcling to the building diagram speuTied in Item A7. U(�U � Benchmark Utilized PINELLAS BM."AURAL A"Vertical Datum NAVD88 Z Conversion/Comments NGVD29-0.86 FT.=NAVD88 �'j o � Check the measurement used. o a r--� N LLl a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 5.¢ �feet ❑meters(Puerto Rico only) ►.c� b) Top of the next higher floor 15.2 �feet ❑meters(Puerto Rico only) t(�N O � c) Bottom of the lowest horizontal structural member(V Zones only) N1A. ❑feet ❑meters(Puerio Rico only) U n: d) Attached garage(top of slab) 5.6� ._ "�, �feet ❑meters(Puerto Rico only) (L�J w °i�� 0 G�� e) Lowest elevation of machinery or equipment servicing the building _ , �feet ❑meters(Puerto Rico only) �J (Descri6e type of equipment in Comments) 1J � , 2' � Lowest adjacent(finished)grade(LAG) �`"t �� 3.2 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)g�ade(HAG) 5.3 e feet ❑meters(Puerto Rico only) t �'�' 0. SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. I certify that the information on ihis Certificate represents my best etForts to interpr�t the data available. 1 understand that any false statement may 6e punishable by fine or imprisonment under 18 U.S. Code, Section 100f. �� � Check here if comments are provided on hack of form. � ��,` r G ;.;._.'.... Certifier's Name MICHAEL J. BAKER License Number LS 4086 , . //. .. y ;�?r=�,,. : 1 ND SURVEYOR Company Name MICHAEL BAKER ASSOCIATE3 �Q d'f7 �1��'G' � � .� Ada ess 220 S.SAFF AVE. City TARPON SPRINGS 5tate FL ZIP Coda 34689 l��� )1� U -- -� Signat �, Date DECEMBER 1,2007 / Telephone 727-938-5026 ,. � ��;✓ - , � �, ____ �, ��d��c� - o�� `�3 . � � �: _ � � . , � � ,-- . � ,� >,�� � �,:; � � . .�E.�w`� � " � � � �`�' � l i���� . . �� . ������� � � ����� � � .� ����� � ��;,�- . . . . .. . . . . � r'�� • \. . � . � � � � ��� ����� �� �� � • � ` . i \ V�' "_ V. . . ..� 3y '•� ^. 7. - . IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building StreetAddress(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 442 MIDWAY ISALAND City 6LEARWATER StateFLZIP Code 33767 Company NAIC Number SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) py both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)buildin wner., ,, Comments C2(e). BOTTOM OF ELECTRIC METER BOX(AIR CONDITIONING CONDENSOR ELEVATION 4.6). f � Signature �� � ��'�` Date 12/01/2007 ❑ Check here if attachments SE ION E-B DING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawi space,or enclosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(including basement,crawl space,or enGosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the tING. E4. Top ot platfoRn of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or�betow the HAG. E5. Zone AO only: If no flood depth number is a�ailable,is the top of the hottom floor eievated in accordance with the community's floodplain management ordinance? []Yes ❑ No ❑ Unknown. The local official must certiTy ihls informaUon in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,8,end E are correct b the best of my knowledge. Propehy Owner's or Owners Authorized Representative's Name dress City State ZIP Code Signature Date Telephone Comments._ , ,_ ..__...__,�. -. . ❑Check here if attachments :. ± SECTION G-COMMUNITY INFORMATION(OPTIONAL) " :�. The local official whd is authorized by law or ordinance to administer the communiry's floodplain management ordinance can complete Sections A,B,C(or E), _; and G of this Elevation Cert�cate. Complete the applicable item(s)and sign below. Chedc the measurement used in Items G8.and G9. _ ';',G1.�: The infoRrration in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who - is authoriz�d by law to certify elevation infortnation. pndicate the source and date of the elevation data in the Comments area below.) �.'G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. .- �.:,G3.❑ The�o'Ibwi�g information(Items G4.-G9.)is provided for community floodplain management purposes. . ,� ' _•� . G4.Permit N�p�be, G5. Date Permit Issued G6. Date Certificate Of Compliancs/Occupancy Issued � . _ .� r ;; G7. �been issued for: ❑New Construction ❑Substantial Improvement G8. levation of as-built lowest floor(including basement)of the building: _�feet �meters(PR)Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum Local Official's Name Title Community Name Telephone Signatura _.. :. � Date : r:w •, �: _.. .. �4 �-r.-- � . • �mmen�s ;: f — . � :, : +i 't �rl' ❑Check here if attachments � � Building Photographs See Instructions for Item A6. For Insurance Company Use: , uilding Street Address(including Apt, Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 442 Midway Island C ity State ZI P Code Company NAIC Number Clearwater Florida 33767 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. � � ., ' � � � . _ , 1-:�._r,- s�le'!� , � . ,. � ,�, - ��� � � � o.. a. .� 4 . `. , # � _ . ,;� , ..,. : —_ —,�. ;. , . - . �4. _ - �'� , � � � � a - � 3 1 � - _ : � : ;: i _ 3 a' � �t- _ } � � _F. j -- .<��.. �N � � �` � j��'`� �� i _...€.,` j i � � � a' � � _ � . . . � � � � .� '�� i� �` -_ � � �� � - . � . u . � �' � � _ � ! �� , i � ¢ ', �. � �� -_ _: ��� � �, � , , � : �� . �� :} - _` - —� 4 � j � ���� � - _ � . � � _ _ . w , :F � � _ ���E �., � � .� � � � �� �� _ � � � �,,� � - -�., .� . . � - .,. � --- - -� r � � : , ,� -�: �f - �� � � --_ � � � , _ �,.. . _ : ; � � _ � � _ - ; � ; - .� � � �`� j ��'� �.., ..- 4� -',y; � �'\_ : x: °_�. .. ., i �- � � � ; _ - �. ',: � ` ,, i a ,�..�� � s � '� � � — �� � � �a ' � — r � � �' ' v ' "� � � Ea E�f+t �� ? �__ � � � ` �� _.3� ' ' �p g` ,����° � �� � �' � -- 3 , . . .__...�. =q-.,. �'� i . ., . +'�. ` rE-._., _...:..w�.,: r_..,`' `_ ;m, FRONT VIEW � REAR V �' � � � ��' ��1 "�� • �r � iI ', � ���,ll �. DEC f� 5 201;� �%� � / p�wM�N�&a�v��opa��r�-r svcs ;�_ C1TY_OF CL�ARWA�ER . � . Building Photographs . , Continuation Page , For Insurance Company Use: Polic Number Building Street Address(including Apt, Unit,Suite, and/or Bldg. No.)or P.O. Route and Box No. v 442 Midway Island ' ity State ZIP Code Company NAIC Number Clearwater Florida 33767 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front Vievw' and "Rear View"; and, if required, "Right Side Viev+r' and "Left Side View." i � 1 � t'x� I ' � 1 • � �`� + ���= t � � 4�� r ��� � � y �}+ v�..� � � \ .. '.t 1/. .g P� � ♦... .�++� � �._, :ar�'r... . 1� - � �;�-� �i ` � � , ^ �� ,�: ` x- z . � � i _ 4 ��. ' ..� ?x r`-��+¢°�' p,r,.:. 1 � :/ 1 t _ - c �,, �.. `.ns�';",. ' �,...,.�,-�+"�.-+°'":: � �a ��� � �� � � � ���_ � ,�t� r� � ��� �� _ f� .... � � �' �1�1 ;,,,. � � Q � � d � ��C p � 2007 • P{,pr1NING&DEVEIflPMENT SVCS � C1TY DF CLEARWATER ,� � � SIDE VIEW � ✓� �� '/ � Y'- ', l ,^, -- � � ��- �,�'�%, I , �, � Building Photographs • Continuation Page For Insurance Company Use: Building Street Address(including Apt, Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poi�cy Number 42 Midwa Island Y City State ZIP Code Company NAIC Number � Clearwater Florida 33767 If submitting more photographs than will fit on the preceding page, a�x the additionai photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side Viev�' and "Left Side View." ; t �'�: \ � �' 1+ .,� +� \ , , / � ^' �`� � ..,� 't � . , / , . � � , e " \ . / \ II � ���� , �i. ,.��'-�,'. a �s�' �� ?1 ° � , i . ,� � 'r .� „��ga � , ^1�� �� , . 'y �' 'y�y-, . i '� ;`� 'i � � ��''' ��� �� �'�, ��'�� .���� � , � + I � ` M � \, � � � � � � � I _'�� �(p II ^-'� ' a`�\...\ . �� . , �. f' �I ,,r�_� � � � � I . �� ;�' �\ �� ��..� � � ,.,� � , '�'� ..y: .. �. .... -,q - . � x$e, _.w�� �.� "''�_. , s _t��� � '�,• ' � � ; ..._ �� . . a . . � ��,. ; �. �I � � �r , � , . .. . , �.,,� .. 4. �� _�re b '1 �,:� �, '� ,� � t � �. � r..� � f r [ f�; _ I�� k . . � �, , .::,.� `� E y � -- i� � � � . ..� .;.., i � ; :s'; „.,.� _ . _ ; . ; _.�-- l _ , __ ___ - __ ,,�� -�M� � . �� � � ' �� ts �. � � QC��_d � � � ���� � � �oo- • p�AtdNINC�&DEVEI.OPMENT SVGS CITY DF CLEARWATER ; /;, /, ;, SIDE VIEW � �, , , J' ,, ,.�,: ,; ..._.___. % i ! } . . � 'R���r�r-x2� ��,�����°��� a,�� `�, �� �,� C ITY O F C LEARWATE R � �v",� � ��e'°-�1�_=� p� DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT Rf�"�--_ ��Y ���----�-� PosT OFF��E BoX 4748, CL�Wn�R, F�.oa�DA 33758-4748 ��R, i����� �"�`�.° � �y MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CI.EARWATER,FLO�uDn 33756 ��°`��'`�� TF�EPxoNE(72� 562-4567 F�(72� 562-4576 MEMO OF REVIEW FOR CORRECTNESS 8� COMPLETION In accordance with participation in the NFIP/CRS program, all elevation certificates are required to be reviewed for correctness and completion prior to acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of elevation certificates. The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community The attached elevation certificate is complete and correct X Minor corrections have been made in the below marked sections by Community O�cial SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Policy Number A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number City State ZIP Code A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) A5. LatitudelLongitude:Lat. Long. Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage,provide: . a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage sq ft b) No. of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade c) Totai net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION B1. NFIP Community Name&Community Number 62.County Name B3.State B4. Map/Panei Number 65.Suffix 66. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C-0102 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile ❑ FIRM ❑Community Determined ❑Other(Describe) 611. Indicate eievation datum used for BFE in Item B9: ❑NGVD 1929 ❑NAVD 1988 ❑Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date ❑CBRS ❑OPA SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized Vertical Datum Conversion/Comments Check the measurement used. e) Lowest elevation of machinery or equipment servicing the building 14 . 6 �feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) Comments: �of Review: Community Official: 1 e/evation certificates shall be maintained by the community and copies with the attached memo made available by request FRANK HIRBARD,MAYOR GEORGE N.CRE7'EKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMEMBER PAUL F.GIBSON,COUNCILMEMBER � CARI.EN A.PE"1'ERSEN,COUNCILMEMBER ��EQUAL EMYLOYMENT AND AFFIftMATIVE ACTION EMYLOYER� � . � , ' /,t/ a� � , . . �.�_ S/.� �i� �� . � . � f �� �� �s�� — _ _. � _ . �_ __ ___.__..�____ _ __ _ _w f��:a-�ea..-_�__-.�lv _ �_�._. . . _ . ' _,� --_ ____ .�.__�____._ . _ . _ ... _._ _._w �.�__ __. � . __.. � ' _ __ : _.�..___..��.__�:�;�-�W_�-��-_ _.. ._. . �� ____. ______. _ _____ __ _._ _ . � . . _ �- �� .�.__�_��_._ .. ., ,_._ __ .___. 6� � _..___ ,�._____�,!'c�� _ j _____..:�__.. �-------- . _ � _ . � �_.__._. .. _� ___ _��!..�.� .__ ��---__:�_ � �/��[,-/�ry� r./���.:..._—.►-}���� ti../:..,�.�.�.___�._..._..._._._��....�...__.._.-,.._....�.W�.._._,.,_.._._... _`---'` ____.__-�r�v 'ff ��'. _ _ __ _ _ _ _ __--- � � � s '' , � ��� �.�. � � ,� � . � �� � �'1 � �� R-` ����' � j � r� ciycii�.� �riu���y..i�i..�i...y..��..� 3t�o�ai Fioo�ir,surance Program important: Read the instructi�ns on pages 1-8. �� ' _ , . ,. SECTION A-PROPERTY INFORMATION For Insurance Company Use: �' , ng Uwreer's Name ARTHUR NETHERCOAT Policy Number �. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number �42 MIDWAY ISLAND City CLF�aRWATER State FL ZIP Code33767 a3. Property 7escription(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) _OT 60, UNIT 3 iSLAND ESTATES OF CLFARWATER . a4. Building Use(e.g., Residential, Non-Residentiai,Addition,Accessory,etc.)RESIDENTIAL �5. La[Itude/Longifude:Lat.27 DEG 58'S9"N Long.82 DEG 48'49"W Horizontal Datum: ❑ NAD 1927 � NAD 1983 a6. Attach at least 2 photographs of the buifding if the Certificate is being used to obtain flood insurance. >7. Building Diagram Number6 A8. For a building with a crawi space or enciosure(s),provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage oF attached garage 2179 sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade _ c) Total net area of flood o enin s in A8.b 0 s in c Total net area of flood o enin s in A9. 1582 s in SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION 31.NFIP Community Name&Community Number B2.County Name B3.State �ITY OF CLEARWATER 125096 PINELLAS FLORIDA B4. Map/Panel Number B5. Suffix 66.FIRM index 67.FIRM Panel 68.Flood 69.Base Fiood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO, use base flood depth) 12103C0102G G MAY 17,2005 BEPT.3,2003 AE _ 11 10. Indicate the source of the Base Fiood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile �FIRM ❑ Community Determined ❑Other(Describe) I 1. ate elevation datum used for BFE in Item 69: ❑ NGVD 1929 �NAVD 1988 ❑Other(Describe) .,,�e buiiding located in a Coascal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Jesignation DateNONE ❑CBRS ❑OPA SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIREDj i. Building elevations are based on: ❑ConstruCtion Drawings' ❑Building Under Construction' � Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. � ?. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,Vi-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete I s_C2�a-g below according to the building diagram specified in Item A7. `l't� � Benchmark Utilized PINELLAS BM."AURAL A"Vertical Datum NAVD88 ' � r�. � Conversion/Comments NGVD29-�.86 FT.=NAVD88 �f' o Check the measurement used. ( � � Top of bottom floor(including basement,crawi space,or enclosure floor)_ 5.6 �feet ❑meters(Puerto Rico only) ��° � {ii b) Top of the next higher floor 152 �feet ❑meters(Puerto Rico only) � � ;u c} Bottom of the lowest hor¢ontal sWCturai member(V Zones oniy) N/A. ❑feet ❑meters(Puerto Rico only) :� �' d) Attached garage(top of slab) 5.6 �feet ❑meters(Puerto Rico only) �6 _� � e) Lowest elevation of machinery or equipment servicing the building 11.0 �feet ❑meters(Puerto Rico only) ? (Describe type of equipment in Comments) !'�'� • � � Lowest adjacent(finished)grade(LAG) 5.2 �feet ❑meters(Puerto Rico only) � � g) Highest adjacent(finished)grade(HAG) 5.3 �feet ❑meters(Puerto Rico only) �-�--�Yr-"��'� ,p SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION -his certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation �formation. I certify that the information on this Certificate represents my best efforts to interpret the data available. understand that any false statement may be punishable by fine orimprisonment under i8 U.S. Code, Section iDOL !��.�' %" ,, j', ;; /'j;;". � //' ,ti � Check here if comments are provided on back of form. ,� /.� -�-� /����/' ' �/ "%,��,�".��. �� � r : _ �j� � �__ ;er' � Name MICHAEL J.BAKER License Number LS 4086 •`�� ���_;- .� ..��,,,�..: � , ,�N �l' Y?r;,, �4ND SURVEYOR Company Name MICHAEL BAKER ASSOCIATES '�;�.'' ' ��' '! G:' !. ,; ;. �ddress 220 S.SAFF.ORD AVE. City TARPON SPRWGS State FL ZIP Code 34689 _ % ,� _ , , /, :ignature' '% `% �, Date DECEMBER 1,2007 Telephone 727-938-5026 � ., /� _ _ ;� '�(�;�nr�� _ t^���.CI�2 a - ;�F ` r�'�� „ - ���. � . .. , �...., .. � u�'.-.� , :,` k � � t� � � � ,,.e . . .. . t.•:, . . � ,�. z• ,. ,�},.., a �, . >. . � r � � �� ��,� ` - _,...� . . `Y.-•"' , �.,.. �� ..�� , _ , � � �,���.�,,x�a«. . _ ,,�,��..«,��.,..�,.�-r� :_ � _, z _ , �� .�z:,;.. ;�� . ' ,� , _ , . ,�; , ,� � . � . � " � ;.� : r �, ' r _ _ , � �> . . ,. , � . ,r �� �� r,. .,�� � ' �lr . ", s�. .. : � � ,�� � � .,�`l } r�"", ,. !� �. .. ;• � * �, "' `• ° � " '. Fa. ,_ , _- . .. . I, _> '��,� ,. � .;.,,. ., ,✓ r�,, � � . .�,�„ �,�''�' . � , , .. • «; � • , . x�� �4° f - � � �a� , .�.� � � x°;• , ,_ �, �� -. . . �� . , .. , � � �, . ;. � , = �, _ � � . 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